ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138431.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138432.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138433.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo outline the spectrum of eye injuries in the Victorian population.Design and settingProspective survey of all eye injuries treated at the Royal Victorian Eye and Ear Hospital; and a review of morbidity data from all Victorian hospitals to estimate the incidence of ocular trauma across the State.ResultsDuring a 12‐month period, 6308 patients were treated at the hospital. Most had superficial injuries, but 401 (6%) were admitted for severe trauma. Most were male and young; children aged under 15 years comprised 25% of hospitalisations (severe injuries). The workplace accounted for 44% of all injuries and 19% of severe trauma, including ruptured globes and internal bleeding. Sports injuries accounted for 5% of all injuries, but 19% of severe injuries. The incidence estimate for penetrating eye injuries was 3.6 per 100000 population. The incidence of eye injuries requiring hospitalisation was 15.2 per 100000. Annual medical costs were estimated conservatively at $15.8 million a year for this hospital alone and projected at $39 million a year for 29000 eye injuries in Victoria and $155 million a year for 116000 cases nationwide.ConclusionsMost ocular trauma occurs in young people and could be prevented by proper use of safety eyewear.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138434.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectivesTo improve the initiation of anticoagulation in patients with thrombotic disorders.Design and settingWe carried out a preliminary audit in 1991, developed and implemented strategies to address identified problems, and followed up with another audit in 1993. Medical records of inpatients at The Royal Melbourne Hospital whose anticoagulation therapy was initiated with heparin (intravenous) in therapeutic doses and subsequently converted to warfarin were prospectively assessed over 19‐day periods.InterventionPocket‐sized laminated prescriber guidelines for initiating anticoagulation were disseminated after publishing the results of the first audit, together with a single prominent display of two posters in series advocating the use of the guidelines.ResultsThe audits identified 25 eligible patients in 1991 and 27 in 1993. The mean duration of intravenous heparin therapy was reduced from 150 hours in 1991 to 97 hours in 1993 (P<0.002). The mean delay before initiating warfarin therapy after starting heparin therapy was reduced from 69 hours in 1991 to 21 hours in 1993 (P<0.002). The mean percentage of time the activated partial thromboplastin time was within the therapeutic range increased from 30% in 1991 to 44% in 1993 (P<0.05) and was above the therapeutic range increased from 13% in 1991 to 24% in 1993 (P<0.01). Although the number of adverse events was too small to draw definitive conclusions, no difference in adverse haemorrhagic effects was noted between the 1991 and 1993 groups.ConclusionThere was an improvement in the initiation of anticoagulation and we hypothesise that this was most likely due to a broad acceptance of the guidelines into clinical practice.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138435.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectiveTo perforin and evaluate an educational intervention program aimed at improving the dosage prescribing of allopurinol by general practitioners and based on the application of academic detailing.Design, setting and participantsGeneral practitioners in southern Tasmania were sent educational material about allopurinol, highlighting the need to adjust dosages in accordance with the renal function of the patient. Most general practitioners then discussed the rational prescribing of allopurinol directly with a visiting pharmacist.Main outcome measuresPhar‐macoepidemiological data provided by a statewide database containing dispensing data from community pharmacies throughout Tasmania, and Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) data. The key variable was the percentage of prescriptions for allopurinol that were for the 100 mg form.ResultsThe program's success was indicated by a statistically significant increase in the prescribing of 100 mg allopurinol in the intervention region. The database showed an increase from 14.8% to 22.1% of all prescriptions for allopurinol (P<0.05), while PBS and RPBS data revealed an increase from 12.5% to 22.2% of all prescriptions for allopurinol dispensed under both schemes (P<0.0001).ConclusionsA program incorporating academic detailing can modify prescribing practices within the community. A statewide phar‐macoepidemiological database provides a valuable means of evaluating interventions designed to improve prescribing.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138436.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138437.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

ObjectivesTo determine asthma morbidity, use of medications and trigger factors for asthma attacks in an adult community sample.MethodsFollow‐up questionnaires were sent to respondents indicating a history of asthma or any respiratory symptom on a screening questionnaire. A new scale to measure asthma severity was developed.ResultsQuestionnaires were returned by 74% (589/795). Respondents with diagnosed asthma had more frequent symptoms and more disruption to lifestyle than those with non‐specific respiratory symptoms. Inhaled β‐agonist and oral theophylline preparations were used by 61% and 16% of asthmatics, respectively. Preventive medications such as inhaled corticosteroids and cromoglycate were used daily by only 15% and 4%, respectively. The most frequently reported trigger factors were viral upper respiratory tract infections, cigarette smoke, house dust, smog and other nonspecific irritants. Twenty per cent of asthmatics reported occupational exacerbation of symptoms.ConclusionsThere is substantial morbidity from asthma in Victorian adults, which could be reduced by greater use of preventive medications, avoidance of trigger factors, peak flow monitoring and action plans. The asthma severity scale proved to be reliable and valid.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138438.x

出版商:Wiley    

年代:1995

数据来源: WILEY

摘要:

Of 100 patients having chemotherapy who were given a written information and consent form, only 34 understood the purpose of the form and only one considered it the major source of information; 75 patients could not name any of their drugs, 26 did not know the goal of therapy and only 15 remembered all of four general side effects. Such forms may not satisfy the requirements of informed consent.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138439.x

出版商:Wiley    

年代:1995

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1995.tb138441.x

出版商:Wiley    

年代:1995

数据来源: WILEY